Outsourcing Medical Coding Thank you for taking the time to … · 2019-03-30 · Coding. Coding Compliance & Auditing Services. Coding Denial Management Services . Clinical Documentation
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How It Can Pay For Itself Benefits with Aviacode November 15, 2017 Outsourcing Medical Coding
Thank you for taking the time to meet with us. Aviacode is looking for not for customers, but for partners.
Today’s Coding Challenges
Manual ProcessesUncertified Coders
Duplicating Data Entries
Inconsistency Among Staff/Coders
Turnover/ Absenteeism/ Leave/PTO
Changing Rules & Regulations
Insufficient Quality Assurance
Inadequate Training
Presenter
Presentation Notes
Today’s coding has a lot of uncertainty and challenges. Nod your head if you have these challenges. Why the Problems Exist: As hard as you try there are too many factors that are working against you. Manual Processes – human error Uncertified Coders – lack of knowledge Duplicating Data Entries - Inconsistency Among Staff/Coders – raises red flags Turnover/Absenteeism/Leave/PTO – Shortages, training and re-training Changing Rules and Regulations – Hard to keep up Insufficient Quality Assurance – no arms length, no resources Inadequate Training –
$64K+ Lost Per Physicianfor Under Coding
What’s the Risk?$10 Billion in Penalties
CMS Recovery Audit Program’s Report 2011-15
American Academy of Professional Coders (AAPC) Survey
Presenter
Presentation Notes
There are significant risks not only in penalties, but for undercoding or overcoding without experienced resources at the helm in coding or auditing. These numbers are more on the professional coding side, but is just as much an issue for facilities. The Effects You should be prepared to be audited at some point You risk: Penalties - 10 billion over the last 5 years (RAC Report to Congress) The cost of appeals - $110+ per claim and typically take 1 to 2 years creating cash flow issues (survey conducted by the Frank Cohen Group 2014) Exposure (bad publicity) Even if you’re not audited, it’s likely your losing tens of thousands of dollars per year in under coding and you don’t even know it. There is a delicate balance of both under coding and over coding for lost revenue and penalty risk.
Facility Coding
Professional Fee Coding
Coding Compliance &
Auditing Services
Coding Denial Management
Services
Clinical Documentation
Review & Consulting
Presenter
Presentation Notes
While we are not a RCM company, we are focused strictly on medical coding. We are unique in being able to do pro-fee, facility and risk adjustment coding. This is what we’re focused on, which is medical coding.
We’ve Been Coding Nearly 20 Years
$50,103,365,534MEDICAL CODING REVENUE BILLED
(THAT’S BILLIONS!)
1,000+MEDICAL CODERS
8,800+PHYSICIANSWE SERVE
110EHR INTERFACES
61+MEDICAL
SPECIALTIES
[ Yes, we are busy coding! ]
50STATES WHERE
WE DO BUSINESS
CODING RULES WE USE
7,198,516
Presenter
Presentation Notes
A brief resume Founded in 1999 Based in Salt Lake City, Utah Aviacode provides coding services in all 50 states We have a successful and sophisticated coding process Aviacode codes over 7 million charts and encounters per year For thousands of providers For every specialty Within the ProCoder we have a 3M engine that has coding rules, which is state-specific, career-specific, or client-specific. We also can VPN into your systems. The choice is yours.
As opposed to a Mission Statement, this is how we’re going to help you: We solve your coding problems We improve your Revenue Integrity Cash Flow Compliance
Rapid Deployment &
Scalability
Optimize Reimbursement
Coding-Related Denial
Reduction
Backlog Elimination
Coding Accuracy & Compliance
Coding Standard Enforcement
CoreStrengths
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Presentation Notes
What we do. Our positioning statement is focused on what we do best Coding Accuracy & Compliance Rapid Deployment & Scalability Backlog Elimination Optimize Reimbursement Coding Standard Enforcement Coding-Related Denial Reduction
QA Benefits
Catch errors before they become a problem
See fast, actionable
results
Manage and mitigate risk
Understand risk and exposure on
payer audits
Optimize reimbursement
$
Presenter
Presentation Notes
Why QA? Quality Assurance not only helps being proactive ahead of problems, but also helps minimize your risk and exposure on audit. The end result is optimized reimbursements.
Sample Audit ReportsSurgery E/M
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Presentation Notes
Here are examples of sample audit reports. We can provide examples as needed.
Save Up to 20% Off Your Coding/Coding Audit Needs
Services Standard PricingScripps Mercy Physician Partners
PricingSavings
Coding*E&M $4.25 $ 3.50 18%
*Surgeries $10.00 $ 8.00 20%
*Surgeries Extensive $12.50 $ 10.00 20%
Coding Review PackageE&M/Surgeries10 encounters each month with 30 minute review
$200.00 each month $165.00 each month 18%
Auditing Review PackageE&M/Surgeries15 encounters each quarter with 1 hour review with detailed findings report
$625.00 each quarter $500.00 each quarter 20%
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Presentation Notes
We have special pricing for Scripps Mercy Physician Partners.
Aviacode Partner Vision
Improve Coding Process
Reduce Risk
Optimize Reimbursements
Accelerate Revenue Cycle
Be Your Coding Partner
Presenter
Presentation Notes
In summary, we see ourselves not as a vendor, but as a partner with you. We are not just a people or staffing solution. We are coming in to understand your process – understanding the people and process problem. By covering all of the issues of medical coding, we want to help make them better. These include improving the coding process, reducing the risk, optimizing reimbursements, and accelerating the revenue cycle. All of which underscores our desires to being your coding partner.
